Synthetic Cannabinoid Illnesses in FL - May 2014

In the news today is an outbreak of synthetic cannabinoid-associated illnesses in Florida. This report out of Gainesville, FL states that 28 people have been hospitalized over the past 48 hours. The products associated with these illnesses have, at least initially, been traced to a local smokeshop. Needless to say, the shop was raided and a larger amount of synthetic cannabinoid product was confiscated. Florida has some of the toughest laws on the books regarding synthetic cannabinoids so it'll be interesting to see what actually comes of this.

These newer generation compounds are no joke and I've discussed my reservations about them ad nauseam (here and here and here and here and here). We know nothing of their pharmacology and toxicology. Most of the newer research chemicals are nothing but mix-and-match versions of earlier chemicals or what I like to say is a chemical grab bag o' fun.

The earlier reported outbreak of illnesses related to synthetic cannabinoid use in Texas still hasn't been resolved or at least a chemical has not been identified and its identity released to the media.

As always, if I hear any more information, I'll update.

Cheers,

ForensicToxGuy

Warning: Pesticide Contamination of Synthetic Cannabinoid Products in Florida

There have been recent reports of outbreaks of illnesses from the consumption of various synthetic cannabinoid products. Symptoms reported in these last outbreaks include violent behavior, seizures, and other cardiac issues. Products are just now being analyzed and the specific cannabinoids identified. While the cannabinoids are worrisome on their own, now comes this report from Manatee county, Florida.

The sheriff's office in Manatee county has issued a warning that there may be synthetic cannabinoid products out there that contain the pesticide acephate. Two kilograms of a substance allegedly meant for use in "spice" products was acquired by authorities. The substance was later identified as acephate.

Acephate is an organophosphate pesticide used to control insect pests such as aphids, caterpillars, and sawflies. Its IUPAC nomenclature is O,S-Dimethyl N-acetylphosphoramidothioate. Chemical formula is C4H10NO3PS.

 

According to the World Health Organization (WHO) toxicity class system, acephate is a class III (Slightly Hazardous) substance. Upon heating, acephate decomposes to form oxides of nitrogen, phosphorus, and sulfur.

In insects, acephate is biotransformed into methamidophos, another active organophosphate compound. Methamidophos is also available as the pesticide Monitor. Its IUPAC nomenclature is O,S-Dimethyl phosphoramidothioate. Chemical formula is C2H8NO2PS. According to the WHO toxicity class system, methamidophos is classified as a class IB (Highly Hazardous) substance.

 

 

In humans, tranformation to methamidophos is relatively minor and the major metabolite is O-desmethylacephate. 

What do organophosphate compounds such as these do while in the human body?

They inhibit the enzyme acetylcholinesterase (AChE) via phosphorylation, which ultimately results in an accumulation of the neurotransmitter acetylcholine (ACh) in the body. An excess of ACh can lead to overstimulation of the nicotinic acetylcholine receptors (nAChRs) and muscarinic acetylcholine receptors (mAChRs) which are part of the parasympathetic nervous system (PSNS). 

Adverse effects (alphabetical order) include anxiety, ataxia, bradycardia, bronchoconstriction, bronchial secretions, coma, convulsions, cyanosis, defecation, dyspnea, emesis, headache, hypotension, hyperthermia, lacrimation, miosis, muscle weakness, peristalsis, respiratory depression, salivation, seizures, sweating, tremor, vasodilation, visual disturbances, urination, and urination.

The mnemonic SLUDGEM is useful in characterizing the general effects:

Salivation, Lacrimation, Urination, Defecation, Gastrointestinal motility, Emesis, Miosis

Nature's Poisons recently wrote about nicotinic acetylcholine receptors and resulting effects of activation of said receptors. I previously wrote a short bit on muscarinic acetylcholine receptors and results effects of receptor activation.

For quite some time, I've wondered if something like this would happen. If this is to be believed as legit, then I'm not sure the logic. Other than to harm, what is the reasoning behind using an organophosphate pesticide in a cannabinoid smoking blend? I've seen some strange things contained in blends in the past, but I'm truly bewildered by this one. I don't usually give advice on these topics, but I will do so now.

Stay away from synthetic cannabinoid blends. Do not use them.


If more information is released about this, I'll update.

Stay safe.



References

Baselt, R.C. (2008) Disposition of Toxic Drugs and Chemicals in Man, 8th Edition. Biomedical Publications. Foster City, CA.

Baselt, R.C. (2011) Disposition of Toxic Drugs and Chemicals in Man, 9th Edition. Biomedical Publications. Seal Beach, CA.

Roberts, T, Hutson, D (1999) Acephate. Metabolic Pathways of Agrochemicals - Part 2: Insecticides and Fungicides; The Royal Society of Chemistry: Cambridge, UK, 201-204.

Mahajna, M, Quistad, GB, Casida, JE (1997) Acephate Insecticide Toxicity: Safety Conferred by Inhibition of the Bioactivating Carboxyamidase by the Metabolite Methamidophos. Chem. Res. Toxicol. 10, 64-69.

Farag, AT, Eweidah, MH, El-Okazy, AM (2000) Reproductive toxicology of acephate in male mice. Reprod. Toxicol. 14, 457-462.

Update on Synthetic Cannabinoid Illnesses in TX - 2014

Here is a quick update to the earlier report on the outbreak of synthetic cannabinoid-associated illnesses in Texas.

Reported by CBSDFW.com, law enforcement in Austin, TX have stated that the products were obtained in Dallas, TX and sold by retailers in Austin. 300+ packages of products have been seized from the retailers, but analytical testing has shown that the detected cannabinoids are "not illegal" and therefore, no criminal charges were filed by authorities.

According to KVUE.com, the brand in question is named "The Walking Dead" and they have not yet been able to obtain a full package of the product as it is in "high demand" and a "waiting list" exists for consumers. An empty package of "The Walking Dead" product has been sent to the DEA for analysis on the residue. From my experiences with analyzing these products in the laboratory, it will be quite easy to detect the synthetic cannabinoids, even with only a residue remaining.

MyFoxDFW.com is reporting that the product is either called "The Walking Dead" or "Dead Man Walking".

I'm sure there is still more information to come. But, if any law enforcement officials or medical folks reading this blogpost need help (or simple direction) in analyzing any herbal incense/potpourri/synthetic cannabinoid products or detecting one of these substances in biological specimens, please do not hesitate to contact me at forensictoxguy AT gmail DOT com.

And the beat goes on...

Stay safe,

ForensicToxGuy

Synthetic Cannabinoids Illnesses in TX - May 2014

Recently, there  has been a series of hospitalizations in Texas over what is alleged as synthetic cannabinoid use. From this report by NBCDFW.com, it seems that more than 20 people were treated at Baylor Medical Center last Thursday due to synthetic cannabinoid usage. And then there were 15 people sent to the hospital in Austin. Seizures and violent behavior have been reported, as well as other cardiac issues.

Another report from Dallas states that nearly 120 people were treated for synthetic cannabinoid illnesses over the last five days.

David Kroll has covered these recent outbreaks on Forbes.com as well.

Here is a link to a story about a similar illness outbreak in Mississippi.

No analytical confirmation of synthetic cannabinoids have been presented to the media or published elsewhere for these cases, but I would expect that they are diligently working on this behind the scenes. Of course this is just speculation, but I wouldn't be surprised that this is the work of one of the newer generation synthetic cannabinoids such as AB-PINACA, AB-CHMINACA, or maybe even a PB-22 derivative such as FDU-PB-22. I only know of a lab or two that routinely tests for some of these newer compounds in blood, let alone urine specimens. Also, considering the cat-and-mouse games that are played with these drugs, there may be (and probably is) a new cannabinoid on the scene which we aren't even aware. We must always remember that we know very little (if anything) about the chemistry, pharmacology, and toxicology of these compounds used in herbal incese/potpourri blends.

If a chemical is identified, I'll update.

Stay safe.